Active NPI
Hennepin County
Doing business as Salvation Army Harbor Lights
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- HENNEPIN COUNTY
- Doing business as
- Salvation Army Harbor Lights
- Practice address
- 1010 Currie Ave
Minneapolis, MN 55403-1309 - Phone
- (612) 348-5553
- Fax
- (612) 377-6299
- NPI assigned
- Dec 16, 2018
- Last updated
- Dec 19, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephanie Abel
- Title
- Area Manager
- Phone
- (612) 348-8824
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
1010 Currie Ave
Minneapolis, MN 55403-1309
Mailing address
525 Portland Ave # Mc963
Minneapolis, MN 55415-1533
Phone (612) 348-5553
Other names 1
- Salvation Army Harbor Lights
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040218001012 | MN | Part B Supplier - Clinic/Group Practice | 7911892849 |
Receives reassigned benefits from 194 practitioners 14 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Minneapolis, MN |
| O20190205002099 | MN | Part A Provider - Federally Qualified Health Center (FQHC) | 7911892849 | Practice locations: Minneapolis, MN |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1083185193. Details of each certification follow.
Federally qualified health center certification: CCN 241881
- Legal name
- HENNEPIN COUNTY
- Doing business as
- SALVATION ARMY HARBOR LIGHT CENTER
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Jan 7, 2019
- Last certification
- Jan 7, 2019
- Ownership / control type
- For profit – corporation
- Organization structure
- Government
- Incorporated
- Sep 19, 1989 in MN
- Enrollment address
- 1010 Currie Ave
Minneapolis, MN 55403-1309
Other NPIs with the same Medicare PAC ID 14
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba NorthPoint Health & Wellness- Olson Middle School
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1053729897
7911892849
-
dba NorthPoint Health & Wellness Center- Heritage Park
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1083083752
7911892849
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
7911892849
-
dba NorthPoint Health & Wellness Center-North High School Based Clinic
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1205145448
7911892849
-
dba NorthPoint Health & Wellness Center- Main Clinic
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1215951751
7911892849
-
dba NorthPoint Health & Wellness Center - Franklin Middle School
- Clinic/Center
- Minneapolis, MN
- NPI 1447619929
7911892849
-
dba Catholic Charities, Higher Ground
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1619448685
7911892849
-
dba People Serving People
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1679044788
7911892849
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
7911892849
-
dba NorthPoint Health & Wellness Center- Plymouth Youth Center
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1831408988
7911892849
-
dba Youth Link
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1891266862
7911892849
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
7911892849
Other NPIs on the same Medicare enrollment 14
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba NorthPoint Health & Wellness Center- Heritage Park
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1083083752
O20040218001012
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
O20040218001012
-
dba NorthPoint Health & Wellness Center- Main Clinic
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1215951751
O20040218001012
-
dba Public Health Clinic
- Public Health or Welfare Agency
- Minneapolis, MN
- NPI 1295812386
O20040218001012
-
dba Branch III - Adult Opportunity Center
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1528539624
O20040218001012
-
dba Catholic Charities, Higher Ground
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1619448685
O20040218001012
-
dba People Serving People
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1679044788
O20040218001012
-
dba St. Stephen's Shelter
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1700357779
O20040218001012
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
O20040218001012
-
dba Harriet Tubman Center
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1841761954
O20040218001012
-
dba Youth Link
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1891266862
O20040218001012
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
O20040218001012
National Provider Directory
National Provider Directory- Tax ID family
- Hennepin County Medical Ctr
Other organizations with this tax ID 25
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Minneapolis, MN
- NPI 1003143785
-
- Case Management Agency
- Minneapolis, MN
- NPI 1043345788
-
dba Hennepin County Mental Health Center
- Mental Health Counselor
- Minneapolis, MN
- NPI 1053419580
-
dba NorthPoint Health & Wellness Center- Heritage Park
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1083083752
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
-
dba Emergency Mental Health Services
- Clinical Social Worker
- Minneapolis, MN
- NPI 1184357097
-
dba NorthPoint Health & Wellness Main Clinic Dental
- Dental Clinic/Center
- Minneapolis, MN
- NPI 1205113560
-
dba NorthPoint Health & Wellness Center-North High School Based Clinic
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1205145448
-
dba NorthPoint Health & Wellness Center- Workforce Center Dental
- Dental Clinic/Center
- Minneapolis, MN
- NPI 1407373202
-
dba NorthPoint Health & Wellness Center - Franklin Middle School
- Clinic/Center
- Minneapolis, MN
- NPI 1447619929
-
dba Adult Shelter Connect
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1487125597
Locations
525 Portland Ave
Fl 3
Minneapolis, MN 55415
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Elizabeth David | Corporate Director | Jun 1, 2018 | 100% |
| Hennepin County | 5% Or Greater Direct Ownership Interest | Sep 19, 1987 | 100% |
| Stephanie Abel | W-2 Managing Employee | Jun 1, 2018 | 100% |
| Bao Vang | Corporate Officer | Jul 1, 2022 | 100% |
| W-2 Managing Employee | Jul 1, 2022 | 100% |
Owners & managing parties with NPI records 14
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba NorthPoint Health & Wellness- Olson Middle School
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1053729897
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center- Heritage Park
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1083083752
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center-North High School Based Clinic
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1205145448
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center- Main Clinic
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1215951751
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center - Franklin Middle School
- Clinic/Center
- Minneapolis, MN
- NPI 1447619929
5% Or Greater Direct Ownership Interest
-
dba Catholic Charities, Higher Ground
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1619448685
5% Or Greater Direct Ownership Interest
-
dba People Serving People
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1679044788
5% Or Greater Direct Ownership Interest
-
dba Hennepin County Mental Health Center
- Psychiatry Physician
- Minneapolis, MN
- NPI 1780790345
5% Or Greater Direct Ownership Interest
-
dba NorthPoint Health & Wellness Center- Plymouth Youth Center
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1831408988
5% Or Greater Direct Ownership Interest
-
dba Youth Link
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1891266862
5% Or Greater Direct Ownership Interest
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
5% Or Greater Direct Ownership Interest
All facility ownership & control disclosures 14
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Hennepin County Medical Center | Hospital | Operational/Managerial Control (100%) | Nov 29, 2006 |
| Hennepin County Medical Center | Hospital | Operational/Managerial Control (100%) | Nov 29, 2006 |
| Hennepin County Medical Center | Hospital | Operational/Managerial Control (100%) | Nov 29, 2006 |
| Mvna | Home health agency | Operational/Managerial Control (100%) | Nov 29, 2006 |
| Hennepin County | Federally qualified health center | Operational/Managerial Control (100%) | Jan 1, 1990 |
| Northpoint Health & Wellness Center | Federally qualified health center | Operational/Managerial Control | Nov 2, 2010 |
| Northpoint Pyc Clinic | Federally qualified health center | Operational/Managerial Control | Nov 2, 2010 |
| Northpoint Olson Middle School | Federally qualified health center | Operational/Managerial Control | Sep 1, 2014 |
| Northpoint Workforce Center Clinic | Federally qualified health center | Other (100%) | Jan 1, 1968 |
| Northpoint Franklin Middle School | Federally qualified health center | Other (100%) | Jan 1, 1968 |
| People Serving People | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 19, 1987 Sep 19, 1987 |
| Youthlink | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 19, 1987 Sep 19, 1977 |
| Catholic Charities Higher Ground | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) | Sep 19, 1987 |
| Endeavors | Federally qualified health center | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Sep 19, 1987 Sep 19, 1987 |
Owned or controlled facilities with NPI records 15
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
dba NorthPoint Health & Wellness- Olson Middle School
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1053729897
Operational/Managerial Control
-
dba NorthPoint Health & Wellness Center - Workforce Center Medical
- Community Health Clinic/Center
- Minneapolis, MN
- NPI 1154774925
Other
-
dba NorthPoint Health & Wellness Center-North High School Based Clinic
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1205145448
Operational/Managerial Control
-
dba NorthPoint Health & Wellness Center- Main Clinic
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1215951751
Operational/Managerial Control
-
dba NorthPoint Health & Wellness Center - Franklin Middle School
- Clinic/Center
- Minneapolis, MN
- NPI 1447619929
Other
-
dba Catholic Charities, Higher Ground
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1619448685
5% Or Greater Direct Ownership Interest
-
dba People Serving People
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1679044788
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba NorthPoint Health & Wellness Center- Plymouth Youth Center
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1831408988
Operational/Managerial Control
-
dba Youth Link
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1891266862
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
5% Or Greater Direct Ownership Interest, Operational/Managerial Control
-
dba Hennepin County Medical Center
- Rehabilitation Hospital Unit
- Minneapolis, MN
- NPI 1033138136
Operational/Managerial Control
-
dba Hennepin County Medical Center
- Psychiatric Hospital Unit
- Minneapolis, MN
- NPI 1356369524
Operational/Managerial Control
Facilities with the same owner 12
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba NorthPoint Health & Wellness- Olson Middle School
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1053729897
Hennepin County
-
dba NorthPoint Health & Wellness Center-North High School Based Clinic
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1205145448
Hennepin County
-
dba NorthPoint Health & Wellness Center- Main Clinic
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1215951751
Hennepin County
-
dba Catholic Charities, Higher Ground
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1619448685
Hennepin County
-
dba People Serving People
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1679044788
Hennepin County
-
dba NorthPoint Health & Wellness Center- Plymouth Youth Center
- Student Health Clinic/Center
- Minneapolis, MN
- NPI 1831408988
Hennepin County
-
dba Youth Link
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1891266862
Hennepin County
-
dba Endeavors
- Federally Qualified Health Center (FQHC)
- Minneapolis, MN
- NPI 1962147413
Hennepin County
-
dba Hennepin County Medical Center
- Rehabilitation Hospital Unit
- Minneapolis, MN
- NPI 1033138136
Hennepin County
-
dba Hennepin County Medical Center
- Psychiatric Hospital Unit
- Minneapolis, MN
- NPI 1356369524
Hennepin County
-
dba Hennepin County Medical Center
- General Acute Care Hospital
- Minneapolis, MN
- NPI 1407897309
Hennepin County
-
dba Mvna
- Home Health Agency
- Minneapolis, MN
- NPI 1770957219
Hennepin County
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Minneapolis, MN
- NPI 1518419522
-
- Physician Assistant
- Minneapolis, MN
- NPI 1598199366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544918400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1545177600000",
"number": "1083185193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE # MC963",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-348-5553",
"fax_number": "612-677-6299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 CURRIE AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554031309",
"telephone_number": "612-348-5553",
"fax_number": "612-377-6299"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HENNEPIN COUNTY",
"organizational_subpart": "NO",
"enumeration_date": "2018-12-16",
"last_updated": "2018-12-19",
"status": "A",
"authorized_official_last_name": "ABEL",
"authorized_official_first_name": "STEPHANIE",
"authorized_official_title_or_position": "AREA MANAGER",
"authorized_official_telephone_number": "612-348-8824"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Salvation Army Harbor Lights",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Minneapolis, MN
- Hennepin County
- Hennepin County (NorthPoint Health & Wellness Center- Antwatin Middle School)
- Hennepin County (Hennepin County Mental Health Center)
- Hennepin County (NorthPoint Health & Wellness- Olson Middle School)
- Hennepin County (NorthPoint Health & Wellness Center- Heritage Park)
- Hennepin County (NorthPoint Health & Wellness Center - Workforce Center Medical)
- Hennepin County (Emergency Mental Health Services)
- Hennepin County (NorthPoint Health & Wellness Main Clinic Dental)
- Hennepin County (NorthPoint Health & Wellness Center-North High School Based Clinic)
- Hennepin County (NorthPoint Health & Wellness Center- Main Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.